You Have a Choice. How to Access ABA providers:

We at Behavioral Outreach Services, LLC understand your need for ABA services as soon as possible, whether that is with our company or with another ABA provider. We want to make sure that you know HOW to check your insurance benefits to see if ABA is a “covered benefit,” and how to obtain a list of in-network ABA providers (if ABA is a covered benefit). This will ensure that you have access to a list of in-network providers to choose from (especially if we have a waitlist).

How to Check Your Insurance Coverage

If You Have CoverKids or TennCare:

If you have CoverKids or TennCare (BlueCare, TennCare Select, United Health Care Community Plan, or Amerigroup), then ABA is most likely a covered benefit IF your child has certain diagnosis such as Autism, Intellectual Disability, etc. ABA may be covered for additional diagnosis but is determined on a case-by-case basis by the insurance company. If you have CoverKids or TennCare, here is how to determine if ABA is a covered benefit for your child, and how to obtain a list of in-network ABA providers:


1.  Call the Member Services/Customer Service telephone number on the back of your insurance card


2.  Ask to speak with a “Behavioral Health Case Manager”


3.  Tell them what your child has been diagnosed with (Autism, Intellectual Disability, etc.)


4.  Ask them if ABA is a covered benefit for your child. Please be aware that you may need to tell them about the problem behaviors your child is having.


5.  Ask them for a list of ABA providers that serve your area. If ABA is a covered benefit for your child, they will then give you a list of names and telephone numbers for in-network ABA providers and/or also help you find an ABA provider that may be able to help you as soon as possible


6.  Write this information down in regards to your phone call to the insurance company:

Date of Call: _________ 

Time of Call:_________ 

Name of the person you spoke with_______________

Ask for a Call Reference Number (write it down):: ______________________________________

Insurance Through Work (Private/Commercial):

If you have Insurance Through Work (Private Commercial Insurance) then ABA May, or MAY NOT, be a covered benefit. Because ABA is such a specialized service, we want to make sure to tell you EXACTLY how to talk with your insurance company in order to know FOR SURE if ABA is a covered benefit or not. Unfortunately, members have been given incorrect information by their insurance company in the past and were frustrated later to find out that ABA was not a covered benefit (it was specifically excluded). So, PLEASE follow these instructions exactly as they are written and use the EXACT phrases given for the best chance at finding out if ABA is a covered benefit on your plan, and how to obtain a list of in-network ABA providers if it is a covered benefit:


1.  Call the Member Services/Customer Service telephone number on the back of your insurance card


2.  Tell the person that answers “I need to know if ABA (Applied Behavior Analysis) is ON the EXCLUSIONS LIST, if it is SPECIFICALLY EXCLUDED”please note: checking this FIRST will save a lot of time, headache, and potentially incorrect information.


3.  If ABA is NOT specifically excluded, ask them “Is it a covered benefit under the medical side or behavioral health side of my insurance?”   

           (circle)  Medical                  Behavioral Health


4.  If ABA IS a covered benefit, ask them “Which diagnosis does the insurance company cover ABA for?”  (Autism, Intellectual Disability, etc.)  

(write down)_____________________________


5.  “How does the ABA provider get pre-authorization for ABA?”(write down)___________________


6.  Ask them for a list of ABA providers that serve your area. If ABA is a covered benefit for your child, they will then give you a list of names and telephone numbers for in-network ABA providers and/or also help you find an ABA provider that may be able to help you as soon as possible


7.   Write this information down in regards to your phone call to the insurance company:

Date of Call: _________ 

Time of Call:_________ 

Name of the person you spoke with_______________

Ask for a Call Reference Number (write it down):: ___________________________________

How to find BCBAs in Your Area:

 If ABA is NOT a covered benefit, you may find a list of BCBAs in your area on the BACB website which is https://www.bacb.com. You may contact them individually to see if they work with children, their service delivery model,  and their rates.